Everisto Opondo MbChb.
Tuberculous (TB) arthritis accounts for 1-3 percent off all the tuberculosis cases globally. Extra-pulmonary TB affects most commonly the spine followed by hips and knees. The diagnosis of knee Tuberculosis can be challenging especially in patients with no obvious pulmonary disease or discharging sinuses. The medical management of osteoarticular tuberculosis is usually augmented by various surgical interventions for ideal outcomes. The role of surgery is both diagnostic, and reconstructive.
The diagnosis has however improved markedly with newer diagnostic modalities but for joint tuberculosis the histopathologic examination of the synovium with demonstration of caseating granulomas is the gold standard.
The development of better diagnostic and therapeutic methods for TB arthritis have improved the outcomes despite resurgence in TB cases globally due to the association with Acquired Immunosuppression Syndrome (AIDS). As the strategies for the diagnosis improve the management of TB arthritis should as well be aimed at better functional outcomes. For osteoarticular tuberculosis the ultimate aim of treatment should be to restore joint function and mobility with minimal disability.View pdf